合并皮肌炎的非小细胞肺癌围手术期临床特点

Perioperative clinical characteristics of non-small cell lung cancer complicated with dermatomyositis

目的分析胸腔镜肺叶切除治疗非小细胞肺癌(NSCLC)合并皮肌炎的围手术期临床特点。方法对6例合并皮肌炎的NSCLC患者和6例不伴皮肌炎的NSCLC患者进行1∶1配对研究,分别施行胸腔镜肺叶切除术治疗。对手术时间、术中失血量、术后肺炎/肺不张发生率、术后伤口恢复情况、术后3 d胸腔引流量、术后乳糜胸发生率、心律失常发生率、围手术期住院时间等进行比较。结果肺癌患者是否合并皮肌炎在手术时间、术中失血量、术后3 d胸腔引流量等方面比较,P>0.05,差异无统计学意义。合并皮肌炎与不伴皮肌炎患者的术后房颤发生率分别为50.00%(3/6)和16.66%(1/6),肺炎/肺不张发生率分别为50.00%(3/6)和16.66%(1/6),住院时间分别为(16.28±3.61)d和(11.11±2.92)d,差异有统计学意义(P<0.05)。结论合并皮肌炎的NSCLC患者肺叶切除术后房颤和肺炎/肺不张发生率较高,围手术期住院时间较长,应引起注意。

Objective To analyze the perioperative clinical characteristics of non-small cell lung cancer （ NSCLC ） complicated with dermatomyositis （ DM） . Methods Six cases of NSCLC complicated with DM received lobectomy and lymph node dissection by video-assisted thoracoscopic surgery. The same kind of operations were carried out in another six NSCLC cases without DM in the same period. The twelve cases in two groups were 1 ∶ 1 matched study. The operation time, operative blood loss, postoperative pneumonia or atelectasis rate, postop-erative wound recovery, thoracic drainage in postoperative three days, incidence of postoperative atrial fibrillation, perioperative hospital stay were compared between the two groups. Results In operative time, blood loss and thoracic drainage volume in postoperative three days, there was no significant difference in two groups （P〉0. 05）. In paients with and without DM, the occurrence rate of atrial fibrillation was respectively 50. 00% （3/6） and 16. 66% （1/6）, the occurrence rate of postoperative pneumonia or atelectasis was respectively 50. 00%（3/6） and 16. 66% （1/6）, and postoperative hospital stay was respectively （16. 28 ± 3. 61） d and （11. 11 ± 2. 92） d. It was of significant differences （P〈0. 05）. Conclusion Compared with NSCLC patients without DM, postoperative atrial fibrillation and pneumonia or atelec-tasis occured more often in the DM cases. And patients with DM have longer hospital stays.